Procainamide

Class Class Ia antiarrhythmic
Chemistry

Aminobenzamide

Routes of administration

Oral and IV

Absorption

Oral bioavailability = 75-95%

Solubility

Highly water soluble; pKa 9.32

Distribution

VOD = 1.5-2.5L/kg; only 15-25% protein bound

Metabolism

Hepatic metabolism of some variable fraction, into active metabolites (NAPA)

Elimination

Half-life 3-4 hours; a significant proportion of the drug is excreted unchanged in the urine

Time course of action

Duration of action is similar to half-life of the drug and its metabolites, ~ 4-8 hrs

Target receptor

Nav1.5 subunit of the fast voltage-gated sodium channels

Mechanism of action

Acts by blocking voltage-gated sodium channels and potassium channels, thereby decreasing the slope of Phase 0 and increasing the duration of the cardiac action potential

Clinical effects

Antiarrhythmic effect, prolongation of QRS, prolongation of QT interval

Literature reference

Giardina (1984)

CICM details of understanding Not specifically listed in the CICM syllabus
Mentioned around Deranged Physiology
Related SAQs